NPIMap

Organization Active NPI

Georgia Eye Institute of the Southeast, LLC

  • Optometrist
  • Bluffton, SC
National Provider Identifier
1417200148
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC
Practice address
80 Baylor Way
Bluffton, SC 29910-8902
Phone
(866) 352-7974
Fax
(912) 352-7946
NPI assigned
Oct 18, 2012
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA EYE INSTITUTE OF THE SOTHEASTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erica Leigh Moreland
Title
Director, Revenue Cycle
Phone
(912) 354-4800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Ophthalmology Physician 207W00000X NU

Addresses

Primary practice location

80 Baylor Way
Bluffton, SC 29910-8902

Mailing address

4720 Waters Ave
Savannah, GA 31404-6292
Phone (912) 354-4800

National Provider Directory

National Provider Directory
Tax ID family
Georgia Eye Institute9 organizations share this tax ID, including this one
Part of
Georgia Eye Institute

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4720 Waters Ave
Savannah, GA 31404
Phone (912) 350-4800

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1417200148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046292",
            "telephone_number": "912-354-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BAYLOR WAY",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108902",
            "telephone_number": "866-352-7974",
            "fax_number": "912-352-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA EYE INSTITUTE OF THE SOTHEAST",
        "enumeration_date": "2012-10-18",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "MORELAND",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "912-354-4800"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.